Les Maladies Non Transmissibles: Un Défi — Stratégie Nationale Prévention des Maladies Non Transmissibles 2017–2024 (Stratégie MNT), Version Courte

Objectives

The 2017–2024 National Strategy for the Prevention of Non-Communicable Diseases seeks to enable everyone in Switzerland to live in good health for as long as possible. It aims to prevent avoidable disease and premature death, detect illness early, reduce suffering and care needs, preserve social participation and productive capacity, improve quality of life for people living with chronic illness, and help contain healthcare costs.[1][2][3][4]The strategy sits within the Federal Council’s Health2020 strategy and concentrates on cancer, diabetes, cardiovascular disease, chronic respiratory disease and musculoskeletal disorders, while recognising wider interactions with mental illness, dementia and multiple social, physiological and behavioural determinants.[2][5][6]

• Reduce behavioural risks, including unhealthy diet, physical inactivity, tobacco use and harmful alcohol consumption, while strengthening protective factors and health literacy.[7][3][8]
• Develop health-promoting living, working and environmental conditions, improve equitable access to prevention, and support health-supporting decisions by individuals.[2][3][8]
• Apply life-course, settings-based and multi-risk-factor approaches, establishing healthy foundations for children and adolescents, strengthening personal responsibility among adults, and preserving autonomy among older people.[3][9]
• Prioritise vulnerable people and groups at increased risk by adapting prevention to differing circumstances, knowledge, values, behaviours, life stages and settings.[3][8][9]
• Embed prevention in healthcare, including screening, early intervention and coordinated care, to improve outcomes and quality of life for people already living with chronic disease.[10][11]
• Strengthen monitoring, research, information, training and framework conditions as core areas of action, alongside coordination, cooperation and financing.[1][12][13][4]

Implementation

The strategy combines individual responsibility, information and behaviour change with structural action to make healthy choices easier in daily life.[2][6]It builds on established prevention programmes concerning alcohol, tobacco, nutrition and physical activity, maintaining proven models while coordinating activity across sectors and addressing emerging challenges.[2][3]Delivery is to involve the Federal Office of Public Health, the Swiss Conference of the Cantonal Ministers of Public Health and Health Promotion Switzerland, alongside healthcare providers, counselling organisations, health leagues, public authorities, insurers, employers, businesses, education and community actors.[6][10][14][4]

• Deliver setting-based prevention through schools, workplaces and municipalities, with measures adapted to local conditions, life phases and the needs of vulnerable groups.[9][11]
• Provide accessible and targeted support, including multilingual services, intercultural interpreting and engagement of trusted people such as midwives, employers and associations; involve affected people in designing services for vulnerable groups.[9]
• Integrate practical preventive interventions into care, including smoking cessation, weight reduction, physical-activity promotion, screening and early intervention alongside treatment.[10][11]
• Strengthen collaboration across professions and beyond the health system, clarify responsibilities, improve care interfaces and networks, and incorporate prevention into care guidelines and standards.[10][11][15]
• Establish a stakeholder conference under the Swiss National Dialogue and an independent expert committee to coordinate stakeholders, exchange experience, transfer knowledge and consider problems in prevention within healthcare.[15][14]
• Develop evidence-based guidelines using scientific evidence, affected people’s needs and quality criteria; support pilot and innovation projects through targeted funding and scientific accompaniment.[15][12]
• Replace the Nutrition and Physical Activity Monitoring System with a national non-communicable disease monitoring system covering disease burden, risk factors, social determinants and at-risk groups, and use findings to identify research and innovation priorities.[12]
• Provide age-appropriate, reliable health information; build self-management capacity among people with chronic disease and relatives; and strengthen prevention competencies through initial and continuing education for health professionals.[12][13]
• Advance health in economic, environmental, education, transport and spatial-planning policy, using active mobility, healthy catering, voluntary business commitments and, where appropriate, legal measures affecting prices, availability, advertising and taxation.[13][4]
• Use resources efficiently, restructure and simplify financing instruments for innovative multi-risk interventions, and develop solutions for currently uncovered prevention services with public authorities, insurers and employers.[14]The source identifies funding gaps in prevention within healthcare and prevention for older people, but does not provide a dedicated strategy budget or quantified allocation.[14]

Monitoring & Evaluation

Monitoring and evaluation arrangements combine baseline burden measures, risk-factor trends, a proposed national non-communicable disease monitoring system, and research-led improvement. Premature mortality before age 70 is identified as an indicator of progress in medicine, health promotion and prevention.[16]

• Track premature mortality and potential years of life lost: in 2013, non-communicable diseases accounted for 49.9% of 109,223 potential years of life lost among men and 59.6% of 60,570 among women, affecting an estimated 5,400 men and 3,500 women.[16]
• Use epidemiological and economic baseline evidence, including disease prevalence, multimorbidity, hospital-treated infarctions and strokes, health costs, smoking, alcohol consumption, diet and physical activity.[5][17][18][19][6]
• Establish a national non-communicable disease monitoring system, replacing the Nutrition and Physical Activity Monitoring System, to collect information on disease burden, risk factors, social determinants and groups at risk.[12]
• Use monitoring findings to observe health trends, identify knowledge gaps, and set or revise research and innovation priorities, particularly for prevention in healthcare.[14][12]
• Develop prevention guidelines and standards using scientific evidence, affected people’s needs and quality criteria for good practice.[15]
• Support practical pilot and innovation projects through targeted funding and scientific accompaniment, with knowledge transfer from research into implementation.[12]
• Coordinate stakeholders through an non-communicable disease stakeholder conference under the Swiss National Dialogue and an independent expert committee addressing prevention within healthcare.[15][14]

Quantitative indicators, target values, reporting schedules, evaluation methods, designated surveillance responsibilities and formal accountability procedures are not specified in the supplied extracts beyond the monitoring, research, coordination and expert-advisory functions described.[8][9][10][15][14][12]

Costing & Financing

The economic rationale emphasises that non-communicable diseases impose substantial direct and indirect costs, while prevention may generate savings and reduce future pressure on the health system. Financing is an area of action, but the extracts provide no dedicated overall strategy budget or quantified funding gap.[2][17][18][14]

• Recognise that non-communicable diseases account for approximately four fifths of Swiss healthcare expenditure.[2][18]
• Account for direct costs: the five most frequent non-communicable diseases were estimated to generate 25.6 billion Swiss francs annually in direct health costs in 2011, approximately 40% of direct health costs; including mental illnesses and dementia raised the share to about 51%.[17]
• Address indirect costs estimated at 15.4 to 29.5 billion Swiss francs annually for the five principal non-communicable diseases, driven chiefly by productivity losses, sickness absence, reduced performance, prolonged absence and unpaid care.[18]
• Plan against rising system costs, with total Swiss health expenditure estimated at about 70 billion Swiss francs in 2013 and projected to reach 79 billion Swiss francs annually by 2017.[18]
• Invest in prevention: Switzerland spent approximately 1.54 billion Swiss francs on prevention in 2013, equal to 2.2% of health-system expenditure, compared with a 3.1% Organisation for Economic Co-operation and Development average.[20][7]
• Mobilise prevention finance from private funds, social insurance and public authorities, while using public-sector financing instruments in line with strategy objectives.[20][14]
• Strengthen resources for prevention within healthcare and among older people, identified as areas with urgent needs and current funding gaps.[14]
• Restructure financing instruments and simplify applications and allocations to support innovative interventions addressing several risk factors.[14]
• Clarify payment for uncovered prevention services, including counselling by health leagues, and develop shared solutions involving public authorities, insurers and employers, including appropriate remuneration for counselling and coordination.[14]
• Use cost-benefit evidence showing estimated returns of 23 Swiss francs per franc invested in alcohol prevention and 41 Swiss francs per franc invested in tobacco prevention, alongside estimated annual tobacco-prevention benefits of 540 to 900 million Swiss francs.[20]
• Consider evidence that workplace health-promotion measures reduced direct and indirect costs by more than 25% and generated savings of more than five United States dollars per United States dollar invested.[18]

No numerical strategy budget, future allocations, unit costs, resource-mobilisation target, quantified funding gap or detailed economic assumptions are specified in the supplied extracts.[19][6][3][8][9][10][14][12][13][4]